Uterine didelphys with unilateral hematometra, hemicolpos, and ipsilateral renal agenesis is a rare m01lerian duct malformation. Uterine didelphys with an obstructed hemivagina is frequently associated with renal agenesis, mostly ipsilateral to the blind vaginal pouch. Accurate early diagnosis and septal resection elevate pregnancy rate and birth rate but it is difficult to find these malfomations until the complication associated with pregnancy was developed. We report a case of successful gestational outcome in the presence of preterm labor due to hematometrocolpora caused by uterine didelphys with unilateral imperforated vagina and ipsilateral renal agenesis with brief review of the literatures.
Birth Rate ; Early Diagnosis ; Female ; Hematometra ; Obstetric Labor, Premature ; Pregnancy ; Pregnancy Rate ; Uterus* ; Vagina

No abstract available.
Dental Enamel* ; Lasers, Solid-State*

Intrathoracic meningocele is a protrusion of the spinal meninges through an intervertebral foramen into thethoracic cavity. The majority occur in association with neurofibromatosis. The authors experienced a case ofintrathoracic meningocele in 26 years old male patient associated with neurofibromatosis, and present conventional CT and CT metrizamide myelographic findings.
Humans ; Male ; Meninges ; Meningocele ; Metrizamide ; Myelography ; Neurofibromatoses

PURPOSE: A scaphoid fractures (SF), an important injury with acute pain, may not be diagnosed on the initial X-rays in the emergency department. Some authors have suggested that several clinical examinations are necessary to reliably confirm the presence of a fractured scaphoid in those patients presenting with an injury clinically suggestive of such a fracture, but without a fracture visible on the initial Xrays. we performed this prospective study to evaluate the efficacy of clinical signs believed to be useful in the diagnosis of a SF. METHODS: We performed a 1-year prospective study on 127 patients with suspected SFs. They were examined on two separate occasions : first in the emergency department and then in the outpatient clinic of the orthopedic department 2 weeks later. Tenderness in the anatomical snuff box (ASB), tenderness over the scaphoid tubercle (ST), and pain on longitudinal compression with the thumb (LC) were evaluated. RESULTS: At the initial examination, the ASB, the ST and LC were all 100% sensitive for detecting a SF with specificities of 40%, 49%, and 59%, respectively. These clinical signs, used in combination within the first 24 hours following injury, produced 100% sensitivity and an improvement in the specificity to 76%. Ninety-one (91) patients had one or more of positive clinical tests, with 18 of those patients having a SF visible on the initial X-ray and five having a fracture diagnosed either by repeated X-ray or CT 2 weeks after the injury. CONCLUSION: Our results suggest that the clinical signs ASB, ST, and LC are inadequate indicators of a SF when used alone and should be combined to achieve a more accurate clinical diagnosis.
Acute Pain ; Ambulatory Care Facilities ; Diagnosis* ; Emergency Service, Hospital ; Humans ; Orthopedics ; Physical Examination* ; Prospective Studies ; Sensitivity and Specificity ; Thumb ; Tobacco, Smokeless

Heterotopic salivary gland tissue (HSGT) consists of salivary tissue in places where it does not normally exist. Usually, HSGT presents as a draining sinus or nodule of the neck. The pathogenesis of HSGT of the neck remains uncertain. But HSGT in the neck is most widely thought to arise from defective closures and ectodermal hetroplasia of the precervical sinus of His. HSGT in the neck is rare and only a few cases have been reported in Korea. We recently experienced a case of HSGT in the neck presenting as a fistula of the anterior lower neck. We thought this as a 2nd brachial cleft anomaly; however, biopsy revealed HSGT. HSGT in the neck should be considered as one of the causes of a neck mass or fistula in children. Herein, we report this case of HSGT with a literature review.

BACKGROUND: Left ventricular hypertrophy is common in chronic renal failure patients and may contribute increased risk of cardiovascular morbidity and mortality. We evaluated the left ventricular morphology and function in renal transplant recipients to find the relationship between hemodynamic changes and morphologic and functional improvement after transplantation. METHODS: Serial echocardiographic evaluations were performed in 27 adults(20 men and 7 women) at the time of transplantaion and posttransplantation 1 month and 4 months. The average duration of hemodialysis was 16+/-24 months(mean+/-S.D.). RESULTS: At the time of transplantation, the hematocrit level was 21+/-6% and posttransplantation 1 month and 4 months, that was increased to 39+/-5% and 42+/-7%, respectively(p<0.001). Left ventricular mass index by echocardiography was decreased significantly from 246+/-87g/m2(pre-KT) to 169+/-38g/m2(post-KT 1 month) and 153+/-40g/m2(post-KT 4 months), respectively (p<0.001). Interventricular septal thickness and left ventricular posterior wall thickness were decreased significantly after 4 months of transplantation. Left ventricular systolic and diastolic dimensions were also decreased significantly after 1 month and 4 months of transplantation. Left ventricular volumes and cardiac output were also decreased significantly. But A/E ratio, ejection fraction and fractional shortening did not change significantly. CONCLUSION: These findings showed that pretransplant high output state was resolved radipidly(within 1 month) but the diastolic function did not improved after transplantation 1 month and 4 months.
Cardiac Output ; Echocardiography* ; Hematocrit ; Hemodynamics ; Humans ; Hypertrophy, Left Ventricular ; Kidney Failure, Chronic ; Kidney Transplantation ; Male ; Mortality ; Renal Dialysis ; Transplantation*

Ventricular tachycardia is an important tachyarrhythmia which is encountered commonly in clinical field. The accompanying manifestations could be variable just from palpitation to sudden cardiac death. The classification of this arrhythmia has not completly settled yet, but in a broad way this arrhythmia is classified according to the prescence or abscence or underlying heart disease, especially coronary artery disease. Recently, therapeutic modalities for this arrhythmia have been changed a lot from classical antiarrhythmic drugs to radiofrequency ablation or ICD implantation although there are still some problems to overcome. We experienced a case of 34-year-old female having an incessant ventricular tacycardia which was abolished after endomyocardial biopsy performed to differentiate underlying myocardial pathology.
Adult ; Anti-Arrhythmia Agents ; Arrhythmias, Cardiac ; Biopsy* ; Catheter Ablation ; Classification ; Coronary Artery Disease ; Death, Sudden, Cardiac ; Female ; Heart Diseases ; Humans ; Pathology ; Tachycardia ; Tachycardia, Ventricular*

BACKGROUND: The triage-revised trauma score(t-RTS) is used for triage in trauma patients in many countries. Recently, the triage score was developed as a new triage method for trauma patients in Korea. The objective of this study was to assess the accuracy of triage for the t-RTS and the triage score. METHODS: The medical records of 1575 consecutive trauma patients visiting the Emergency Center, Masan Samsung Hospital, from March to August 1999 were retrospectively analyzed. The triage score and the t-RTS were taken from the charts completed by the emrgency room doctors and nurses. The accuracies of the two triage methods were compared by using the undertriage and the overtriage rates, receiver operating characteristic(ROC) curve analysis, and a correlation analysis with many physiologic, anatomical, biochemical, and mixed scores(Glasgow coma scale, injury severity score, TRISS, APACHE II and III scores, operation, survival, etc.). RESULTS: The undertriage rates for the triage score and the t-RTS were 22.8% and 38.2%, r e s p e c t i v e l y ( p APACHE ; Coma ; Emergencies ; Humans ; Injury Severity Score ; Korea ; Medical Records ; Retrospective Studies ; ROC Curve ; Triage*

Fibroblast growth factor(FGF) play a critical role in bone growth and development, affecting both chondrogenesis and osteogenesis. The authors believe, many craniosynostosis disorders to be linked with activating mutations in the fibroblast growth factor receptors (FGFRs). In recent studies, detected mutations of the FGFR gene has been reported in some syndromic craniosynostosis patients. So far sequence analysis of FGFR in syndromic craniosynostosis has been reported in many Caucasian patients. But Asian patients, especially in Koreans, only several cases were reported. The authors performed a prospective study, evaluating molecular diagnosis of FGFR 1, 2 and 3 in six Korean patients with craniosynostosis(four with isolated craniosynostosis and two with craniosynostosis syndrome) and four normal child as a control group, by polymerase chain reaction(PCR) followed by direct sequencing methods. The results did not demonstrate, any mutation in normal child but mutations in all six patients with craniosynostosis were seen. Three of four patients with isolated craniosynostosis carried mutation in exon 5 of FGFR 1 and exon 10 of FGFR 3 and two patients with craniofacial synostosis syndrome in exon 7, 10 of FGFR 3. Mutation for the same amino acid residue on FGFRs was not found. But two patients with isolated craniosynostosis and one patient with craniofacial synostosis syndrome had the same mutation pattern in exon 10 of FGFR 3 (Met363Val). Then more investigative attempts are needed to correlate a craniosynostosis and mutation in FGFRs with a large sample of patients.
Asian Continental Ancestry Group ; Bone Development ; Child ; Chondrogenesis ; Craniosynostoses* ; Diagnosis ; Exons ; Fibroblast Growth Factors* ; Fibroblasts* ; Humans ; Osteogenesis ; Prospective Studies ; Receptors, Fibroblast Growth Factor* ; Sequence Analysis ; Synostosis

Iliac vein stenosis is a rare vascular complication of renal transplantation that may compromise allograft function if not recognized and corrected in a timely fashion. Because chronic venous stenosis may remain undiagnosed for several years, a high index of suspicion should be maintained until diagnosing this rare disease. A 56-year-old renal transplant recipient presented with unilateral leg swelling and renal dysfunction 16 years after transplantation. Computed tomography excluded deep vein thrombosis and revealed tight iliac vein stenosis on the side of the renal transplant. Following angiographic confirmation of the stenosis, endovascular treatment was successfully performed with a purposefully designed, self-expanding, venous stent. Ipsilateral leg swelling is an alarming sign for the diagnosis of iliac vein stenosis after renal transplantation. Percutaneous intervention with venous stent placement seems to be a safe and effective treatment of this rare condition.
Allografts ; Angioplasty ; Constriction, Pathologic* ; Diagnosis ; Humans ; Iliac Vein* ; Kidney Transplantation* ; Leg* ; May-Thurner Syndrome ; Middle Aged ; Rare Diseases ; Stents ; Transplantation ; Venous Insufficiency ; Venous Thrombosis